Effect of 6-month supervised exercise on low-density lipoprotein apolipoprotein B kinetics in patients with type 2 diabetes mellitus.
Although low-density lipoprotein (LDL) cholesterol is often normal in patients with type 2 diabetes mellitus, there is evidence for a reduced fractional catabolic rate and consequently an increased mean residence time (MRT), which can increase atherogenic risk. The dyslipidemia and insulin resistance of type 2 diabetes mellitus can be improved by aerobic exercise, but effects on LDL kinetics are unknown. The effect of 6-month supervised exercise on LDL apolipoprotein B kinetics was studied in a group of 17 patients with type 2 diabetes mellitus (mean age, 56.8 years; range, 38-68 years). Patients were randomized into a supervised group, who had a weekly training session, and an unsupervised group. LDL kinetics were measured with an infusion of 1-(13)C leucine at baseline in all groups and after 6 months of exercise in the patients. Eight body mass index-matched nondiabetic controls (mean age, 50.3 years; range, 40-67 years) were also studied at baseline only. At baseline, LDL MRT was significantly longer in the diabetic patients, whereas LDL production rate and fractional clearance rates were significantly lower than in controls. Percentage of glycated hemoglobin A(1c), body mass index, insulin sensitivity measured by the homeostasis model assessment, and very low-density lipoprotein triglyceride decreased (P < .02) in the supervised group, with no change in the unsupervised group. After 6 months, LDL cholesterol did not change in either the supervised or unsupervised group; but there was a significant change in LDL MRT between groups (P < .05) that correlated positively with very low-density lipoprotein triglyceride (r = 0.51, P < .04) and negatively with maximal oxygen uptake, a measure of fitness (r = -0.51, P = .035), in all patients. The LDL production and clearance rates did not change in either group. This study suggests that a supervised exercise program can reduce deleterious changes in LDL MRT.
Stolinski
Michael
M
Department of Diabetes and Endocrinology, Postgraduate Medical School, University of Surrey, GU2 7WG Guildford, United Kingdom. m.stolinski@surrey.ac.uk
Alam
Saima
S
Jackson
Nicola C
NC
Shojaee-Moradie
Fariba
F
Pentecost
Claire
C
Jefferson
William
W
Christ
Emmanuel R
ER
Jones
Richard H
RH
Umpleby
A Margot
AM
D000328:Adult; D000368:Aged; D001055:Apolipoproteins B / Q000378:metabolism*; D015992:Body Mass Index; D008078:Cholesterol, LDL / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D015444:Exercise; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007333:Insulin Resistance; D008079:Lipoproteins, VLDL / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D014280:Triglycerides / Q000378:metabolism
D001055:Apolipoproteins B; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D008079:Lipoproteins, VLDL; D014280:Triglycerides; C517652:hemoglobin A1c protein, human; C030106:very low density lipoprotein triglyceride